Blood Bank Saline

[sarara26]

I recently toured a small lab and in their blood bank it appeared they used BBraun brand 0.9% sodium chloride irrigation USP (isotonic saline for irrigation).  Out of curiosity I tried to look into it a bit to see if that was an adequate practice.  I think I just ended up confusing myself.  The pH range on this saline is 4.5-8.  They do not perform coombs crossmatches at the facility.  Most package inserts for the antisera they use say to use isotonic or normal saline.  Just curious what others think about this. 

[David Saikin]

I never considered my blood bank saline as a critical reagent for the reason that I could always use what was on hand for patient use.  I would not have taken the irrigation product though.  I would use the normal saline for infusion.  Never had to do that but there was no reason I could not.

[B.Bullock]

Until I studied the subject, I too did not think too much about the saline I used in my lab.  But simple, everyday items like saline can have a huge effect on blood bank testing.  The type of saline is extremely important. There is a post that I wrote located on the Quotient website.  Here is the link  http://www.quotientbd.com/us/from-the-q/why-is-saline-so-important-is-one-type-of-saline-better-than-another  A few articles are referenced in the post, and make interesting reading.

[exlimey]

4 hours ago, David Saikin said:

I never considered my blood bank saline as a critical reagent for the reason that I could always use what was on hand for patient use.  I would not have taken the irrigation product though.  I would use the normal saline for infusion.  Never had to do that but there was no reason I could not.

Wow, David, you must live a charmed life if you haven't been tripped up by "bad" saline sometime in your career. Certainly in the vast majority of cases the actual pH of saline has little impact, but there are lots of examples where changing the pH of a test system has deleterious effects. Most manufacturers of blood bank reagents and test platforms now specify pH ranges for saline, essentially requiring the use of buffered saline.

[David Saikin]

13 hours ago, exlimey said:

Wow, David, you must live a charmed life if you haven't been tripped up by "bad" saline sometime in your career. Certainly in the vast majority of cases the actual pH of saline has little impact, but there are lots of examples where changing the pH of a test system has deleterious effects. Most manufacturers of blood bank reagents and test platforms now specify pH ranges for saline, essentially requiring the use of buffered saline.

I don't remember the name of the hurricane that destroyed much of south Fla in the late 80's/early 90's.  I used Dade's blood bank saline.  it was noted at the time that somewhere, somehow in its manufacturing process it was neutralizing the reagent anti-D.  Dade never remanufactured that product after the plant was destroyed.  Otherwise I guess I am a lucky guy - never had to use "normal" saline, but it was always an option. 

[exlimey]

On 1/28/2017 at 0:52 AM, David Saikin said:

It was noted at the time that somewhere, somehow in its manufacturing process it was neutralizing the reagent anti-D.

I vaguely remember that one. There are lots of anecdotes of funky results that were ultimately blamed on the saline in use at the time.

More recently, there have been reports of excess ozone in "blood bank saline" causing inactivation of the S antigen. Apparently ozone is bubbled through saline to sterilize it. In colder months the warehouse is cold and the ozone does not dissipate as quickly. In the summer months it's not so much of a problem.